Registry details
Type
Individual
Primary specialty
Pharmacist
Enumerated
Jan 30, 2020
License(s)
5302412333 (MI)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| MAILING | 4239 E 12 MILE RD | Warren, MI 48092-4141 | 586-558-5560 |
| LOCATION | 4239 E 12 MILE RD | Warren, MI 48092-4141 | 586-558-5560 |
Watch this provider
Get a webhook/email the day this provider is added to the OIG-LEIE exclusion list or appears in an FDA enforcement action.